Hemochromatosis, Multiorgan Hemosiderosis, and Coronary Artery Disease

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Abstract
Objective. —To examine the prevalence of coronary artery disease (CAD) in autopsies of patients with iron-overload syndromes. Design. —Retrospective autopsy study of CAD in cases of hemochromatosis and multiorgan hemosiderosis. Setting. —Registry of nearly 48000 autopsies performed at The Johns Hopkins Hospital between 1889 and 1992. Subjects. —One hundred twenty-three subjects were studied. In a 2:1 control-case ratio, 82 controls matched by age, race, and sex were compared with 41 cases with iron overload. Main Outcome Measure. —Severity of CAD. Results. —Pathological description of the coronary arteries were recorded as advanced or severe in 12% of iron-overload cases(n=41) (mean age, 57.6±13.2 years) compared with 38% of controls (n=82) (mean age, 57.0±13.8 years) (P=.01). The prevalence of three-vessel disease assessed by postmortem coronary arteriography was 11.1% in iron-overload cases (n=18) (mean age, 61.7±12.2 years) compared with 33.3% in controls (n=36) (mean age, 61.1±12.5 years) (P=.04). The odds ratio of CAD with iron overload was 0.18 (95% confidence interval, 0.04 to 0.73). Conclusions. —Iron overload resulting from hemochromatosis or multiorgan hemosiderosis is not associated with an increased prevalence of CAD. (JAMA. 1994;272:231-233)

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